4th Branchial Cleft Sinus Anomaly Presenting as Recurrent Thyroid Abscess in A Child: A Case Report

Authors: Bhatt H* , Kurup B , Periera C , Prabhat D , Joshi R , Gala F , Karkera P and Naik P

DOI: 10.23880/ooaj-16000314

Volume 11, Issue 1

Abstract

Objective: To describe the clinical presentation, diagnostic challenges, and surgical management of a rare fourth branchial sinus anomaly in a two-year-old child presenting with recurrent thyroid abscess. Methods: A 2-year-old child presented with fever and anterior neck swelling. Imaging revealed recurrent left-sided thyroid abscess. Incision and drainage were performed twice. Further evaluation with direct laryngoscopy and MRI suggested a fourth branchial cleft sinus anomaly. Definitive management consisted of left hemithyroidectomy with excision of the sinus tract and electrocauterization of the pyriform fossa opening. Results: The child had an uneventful recovery, with resolution of symptoms and no recurrence at 1 year follow-up. Histopathology confirmed a branchial sinus tract coursing through the thyroid lobe. Conclusion: Fourth branchial cleft sinus anomalies are rare congenital defects that should be considered in children with recurrent thyroid abscesses. A combination of imaging and endoscopic evaluation facilitates diagnosis. Definitive surgical excision with closure of the pyriform sinus opening prevents recurrence.

Keywords: Fourth Branchial Cleft Anomaly; Pediatric Hemithyroidectomy; Recurrent Thyroid Abscess

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